The Different Types of Implantable Contact Lenses

Key Takeaways: ICLs – A Path to Clear Vision

Feature	Description
Types of ICLs	Visian ICL, Artisan ICL
Ideal Candidates	Strong or complex prescriptions, thin corneas, preference for permanent correction
ICL Lens Powers	Up to -20D for nearsight, up to +16D of farsight and up to 6D for astigmatism
ICL Selection	Based on individual needs, vision impairment, corneal health, surgeon’s recommendations

ICLs have revolutionised vision correction, offering a safe, effective, and permanent solution for a wide range of refractive errors. With advancements in technology and expertise, ICLs continue to provide a path to clear vision for an increasing number of patients.

Prescription ranges treatable in the UK and Europe

These ranges differ by country and region, so check the Visian ICL website for local information. The Visian ICL lens range covers 99% of all prescriptions.

Implantable contact lenses (ICLs), also known as phakic intraocular lenses (IOLs), have emerged as a revolutionary treatment for vision correction, offering a safe, effective, and permanent solution for a wide range of refractive errors.

These thin, flexible lenses are implanted between the iris and the eye’s natural lens, providing a discreet and convenient alternative to glasses or contact lenses.

Understanding ICLs: A Technological Breakthrough

ICLs are crafted from advanced biocompatible materials, such as Collamer and PMMA, designed to integrate with the eye’s natural structure seamlessly. Their unique design allows them to be inserted through a tiny incision, eliminating the need for extensive corneal reshaping as in LASIK, LASEK or PRK procedures.

Types of ICLs: Tailored to Individual Needs

The landscape of ICLs is constantly evolving, with various manufacturers offering innovative designs to address diverse patient needs. Here’s an overview of the leading ICL models:

1. Visian Implantable Collamer Lens (ICL): Manufactured by STAAR Surgical, the Visian ICL is a widely used ICL crafted from Collamer, known for its flexibility and biocompatibility. It effectively corrects nearsight up to -20D, long-sight up to +16D and astigmatism up to 6D.
2. Artisan Implantable Phakic Lens: Developed by Ophtec, the Artisan ICL is a rigid ICL made from PMMA, offering stability and durability. It is particularly suited for correcting nearsightedness up to -18D and astigmatism up to 3D.

Ideal Candidates for ICLs

ICLs offer a viable solution for a broad spectrum of patients seeking vision correction:

• Individuals with high or complex prescriptions: ICLs can effectively address refractive errors that exceed the limitations of LASIK or PRK / LASEK.
• Patients with thin corneas: ICLs eliminate the need for corneal reshaping, making them a suitable option for those with thin corneas, which may not be ideal for LASIK or PRK.
• Candidates for permanent vision correction: ICLs provide a permanent solution for vision correction, offering a long-term alternative to glasses or contact lenses.

ICL Lens Powers: Addressing a Range of Vision Challenges

ICL lens powers are carefully designed to match the specific refractive needs of each patient. The range of available powers varies depending on the ICL model:

• Nearsightedness (myopia): ICLs can effectively correct nearsightedness up to -20D, with some models offering even higher corrective powers.
• Astigmatism: ICLs can address astigmatism up to 6D, providing clear and distortion-free vision.
• Longsightedness (hyperopia): ICLs can correct up to +16D of hyperopia. The main limiting factor is the depth of the eye’s front segment (anterior chamber). The ICL needs sufficient space to reside safely within the eye, and hyperopic (long-sighted) eyes tend to be smaller with limited space. Unfortunately, some patients will be unsuitable for ICL due to space limitations.

Choosing the Right ICL: A Personalized Approach

The selection of the most suitable ICL involves a comprehensive evaluation of individual factors:

• Patient’s needs and preferences: Understanding the patient’s lifestyle, vision goals, and comfort level is crucial in selecting the appropriate ICL.
• Type and severity of vision impairment: The severity of the refractive error plays a significant role in determining the ICL model and power.
• Corneal thickness and overall eye health: A thorough eye examination is essential to assess corneal thickness and identify any potential eye health concerns.
• Surgeon’s experience and recommendations: The expertise and recommendations of the surgeon are invaluable in guiding the ICL selection process.

ICL Implantation Procedure: A Delicate Process

ICL implantation is a meticulous surgical procedure performed under local anaesthesia. The surgeon creates a tiny incision in the cornea, typically less than 3 millimetres, and inserts the folded ICL into the eye.

The ICL precisely unfolds and positions itself behind the iris and before the natural lens. The incision is then carefully sealed, allowing for natural healing within a few days.

Stage 1: Preoperative Preparation

1. Comprehensive Eye Exam: The patient undergoes a thorough eye examination to assess their overall eye health, measure corneal thickness, and determine the appropriate ICL lens power.
2. Anaesthesia: Local anaesthetic eye drops are administered to numb the eye during the procedure.
3. Eyelid Speculum: A gentle eyelid speculum is placed to keep the eyelids open and provide optimal access for the surgeon.

Stage 2: ICL Insertion

1. Corneal Incision: Using a precision blade or femtosecond laser, a small incision, typically less than 3 millimetres, is created in the cornea to make an entry point for the ICL.
2. ICL Preparation: The ICL lens is carefully unfolded and prepared for insertion.
3. ICL Insertion: Using a unique delivery device, the surgeon gently guides the unfolded ICL through the corneal incision and precisely positions it behind the iris and in front of the natural lens.
4. ICL Unfolding: Once in place, the ICL gradually unfolds and assumes its natural shape.

Stage 3: Procedure Completion and Recovery

1. Incision Closure: The corneal incision is carefully sealed using a self-sealing technique or fine sutures.
2. Rinsing and Irrigation: The eye is rinsed with a sterile solution to remove any debris or residual materials.
3. Eye Drops: Antibiotic and anti-inflammatory eye drops are administered to prevent infection and promote healing.
4. Protective Eyewear: Patients are advised to wear protective eyewear, such as sunglasses or a shield, for a few days to protect their eyes from dust, wind, and other irritants.
5. Post-Operative Instructions: Patients receive detailed instructions regarding post-operative care, including eye drop usage, medication schedules, and activity restrictions.
6. Follow-Up Visits: Regular follow-up visits are scheduled to monitor the healing process and ensure optimal outcomes.

Post-Operative Care and Recovery: Ensuring Optimal Healing

Following ICL implantation, patients typically experience mild discomfort, such as light sensitivity and blurry vision, which are temporary and subside within a few days. During this period, patients are advised to follow their surgeon’s instructions diligently, including using prescribed eye drops, avoiding strenuous activities, and wearing protective eyewear.

Benefits of ICLs: A Clear Advantage

ICLs offer a multitude of benefits that make them an attractive option for vision correction:

• Excellent vision correction: ICLs effectively address a wide range of refractive errors, including nearsightedness, farsightedness, and astigmatism.
• Permanent solution: Unlike glasses or contact lenses that require ongoing use, ICLs provide a permanent vision correction solution, eliminating the need for daily maintenance.
• Minimal impact on corneal tissue: Unlike LASIK or LASEK/PRK, ICLs do not alter the corneal tissue, preserving its integrity and reducing the risk of complications.
• Safe and effective procedure: ICL implantation has a proven safety record and is considered a highly effective procedure for vision correction.

Long-Term Outcomes and Patient Satisfaction

ICLs have demonstrated exceptional long-term outcomes, with patients experiencing stable vision and high satisfaction levels.

Studies have shown that approximately 96% of patients are satisfied with their ICL results, reporting improved quality of life and a newfound freedom from glasses and contact lenses.

Expanding the ICL Landscape: Innovation Continues

The field of ICLs is constantly evolving, with manufacturers introducing innovative designs and advancements to address patient needs more effectively. Here are some notable developments:

• Foldable ICLs: These ICLs are designed to be folded and inserted through a smaller incision, minimizing surgical trauma and promoting faster healing.
• Toric ICLs: These ICLs are specifically designed to correct astigmatism, providing precise vision correction for patients with this refractive error.
• Multifocal ICLs: Designed to correct the need for reading glasses and clear distance vision.
• Prefilled ICL injectors: These injectors allow for precise and controlled ICL implantation, reducing the risk of complications.

ICLs: A Vision for the Future

ICLs have emerged as a transformative force in vision correction, offering a safe, effective, and permanent solution for a wide range of refractive errors. As technology advances and expertise deepens, ICLs are poised to play an even more significant role in shaping the future of vision care.

Frequently Asked Questions About ICLs

1. What is ICL surgery?

ICL surgery, also known as phakic intraocular lens (IOL) surgery, is a refractive surgery that involves implanting a thin, flexible lens between the iris and the eye’s natural lens. This lens helps to correct vision problems such as nearsightedness, farsightedness, and astigmatism.

2. Who is a good candidate for ICL surgery?

ICL surgery is a good option for people who:

• Have a prescription that is too strong or too complex for LASIK or PRK.
• Have thin corneas that are not good candidates for LASIK or PRK.
• Are not good candidates for other types of refractive surgery, such as cataract surgery.
• Have sufficient depth in the front chamber of the eye, determined by an eye scan.

3. How is ICL surgery performed?

ICL surgery is typically performed on an outpatient basis. The procedure takes about 30 minutes per eye. The surgeon will make a small incision in the cornea during the procedure and insert the ICL. The incision will then heal on its own.

4. What is the recovery time for ICL surgery?

Most people experience some mild discomfort and blurry vision after ICL surgery. This is typically normal and will subside within a few days. Most people can return to their normal activities within a day or two.

5. What are the risks of ICL surgery?

ICL surgery is a safe and effective procedure, but there are some potential risks, including:

• Infection
• Cataracts
• Glaucoma
• Retinal detachment

You will discuss these with your surgeon during your consultation. Fortunately, adverse events are not common following ICL surgery.

6. How long do ICLs last?

ICLs are designed to last for a lifetime. However, they may need to be replaced if they become cloudy or if your vision changes significantly.

7. Can I drive after ICL surgery?

Most people can drive after ICL surgery within a day or two. However, following your doctor’s instructions and wearing sunglasses when driving for the first few days is important.

8. Do I need to wear glasses or contacts after ICL surgery?

Most people do not need to wear glasses or contacts after ICL surgery. However, some people may need to wear reading glasses for near vision.

9. What is the cost of ICL surgery?

ICL surgery costs vary depending on the surgeon, the clinic, and the patient’s needs. However, it is typically more expensive than LASIK or PRK. Expect to pay £6,500 to £8,500 for both eyes, depending on the surgeon’s experience, quality of the centre and the type of ICL needed.

10. What are the benefits of ICL surgery?

ICL surgery offers several benefits, including:

• Excellent vision correction
• Long-lasting results
• No need to wear glasses or contacts
• Safe and effective procedure